title: Video-assisted thoracoscopic surgery for stage I non-small cell lung cancer: long-term survival and prognostic factors.
abstract: The purpose of this study was to evaluate the long-term outcomes of video-assisted thoracoscopic surgery (VATS) major pulmonary resection in patients with stage I non-small cell lung cancer (NSCLC). Of the 411 stage I patients, 318 (77.4 %) underwent complete VATS (c-VATS), while 89 (21.7 %) underwent assisted VATS (a-VATS). There were no intraoperative deaths. There were three deaths (0.7 %) within 30 postoperative days. The 1-, 3-, and 5-year survival rates were 95.1 % (95 % CI, 92.9–97.3 %), 83.1 % (95 % CI, 79.2–87.0 %), and 73.4 % (95 % CI, 68.1–78.7 %), respectively. Univariate analysis by log-rank test revealed that tumor-node-metastasis (TNM) stage, primary tumor (pT) status, and type of resection were statistically significant factors affecting overall survival (OS; P = 0.029, P = 0.025, and P = 0.005, respectively). Less acute TNM stage and less extensive resection were significantly predictive for longer OS by multivariate analysis as well (P = 0.024 and P = 0.006, respectively). In experienced hands, c-VATS or a-VATS can be considered as an alternative to traditional incision in patients with stage I NSCLC. Lower TNM stage and less extensive resection were significantly predictive for better OS. A prospective randomized controlled study on a larger scale is required to reach definitive conclusions regarding the efficacy of VATS relative to other techniques.
authors.forename: Xinguo
authors.initials: X
authors.lastname: Xiong
authors.forename: Wenlong
authors.initials: W
authors.lastname: Shao
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Yin
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Hanzhang
authors.initials: H
authors.lastname: Chen
authors.forename: Yuan
authors.initials: Y
authors.lastname: Qiu
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D013997:Time Factors